心脏彩超参数对射血分数保留心力衰竭诊断及MACE发生风险的评估价值  

Value of cardiac color ultrasonography parameters in the diagnosis of heart failure Heart failure with preserved ejection fraction and the risk of MACE

作　　者：刘思琪 Liu Si-qi(Department of Ultrasound,The Affiliated Hospital of Xinyang Vocational and Technical College,Xinyang 464000,Henan,China)

机构地区：[1]信阳职业技术学院附属医院超声科,河南信阳464000

出　　处：《四川生理科学杂志》2025年第3期546-548,552,共4页

摘　　要：目的:探究心脏彩超参数对射血分数保留心力衰竭(Heart failure with preserved ejection fraction,HFpEF)诊断及主要不良心血管事件(Major adverse cardiac events,MACE)发生风险的评估价值。方法:回顾性收集2022年7月至2023年8月期间于我本院就诊的60例HFpEF患者作为研究组;选取同期于本院体检的60例体检正常者作为对照组。以临床症状、体征、有创性检查如心导管测量/无创性检查如超声心动图等影像学综合判断结果为金标准。分析比较两组心脏彩超参数[左心室射血分数水平(Left ventricular ejection fraction levels,LVEF)、左心房内径(Internal diameter of the left atrium,LAD)、左心室舒张末期内径(Left ventricular end diastolic dimension,LVEDD)及二尖瓣舒张晚期最大充盈速度峰值(A峰)比值(Maximum filling velocity peak(peak A)ratio in late mitral diastolic,E/A)]。根据出院后6 m研究组是否发生MACE事件,将研究组患者进一步分为未发生组和发生组。分析对比未发生组和发生组的心脏彩超参数。采用受试者工作特性曲线(ROC)分析心脏彩超参数对发生MACE事件的预测价值。结果:研究组LAD、LVEDD及LVEF均明显高于对照组,E/A明显低于对照组(P<0.05)。未发生组LAD、LVEDD及LVEF均明显低于发生组,E/A明显高于发生组(P<0.05)。心脏彩超诊断灵敏度、特异度及准确度分别为90.00%、95.00%、92.50%,漏诊率为10.00%;且其预测HFpEF患者发生的AUC为0.939,最佳预测敏感度为92.00%,特异度为91.43%,95%CI为0.846~0.985。结论:心脏彩超在诊断HFpEF患者中的诊断灵敏度较高,漏诊率较低,可为临床评估MACE发生风险提供可靠依据。Objective:To evaluate the value of cardiac color ultrasonography parameters in the diagnosis of heart failure with preserved ejection fraction(HFpEF)and the risk of major adverse cardiac events(MACE).Methods:60 patients with HFpEF treated in our hospital from July 2022 to August 2023 were retrospectively collected as the research group;60 normal physical examination subjects examined in our hospital during the same period were selected as the control group.The clinical symptoms,signs,invasive examinations such as cardiac catheterization/non-invasive examinations such as echocardiography and other imaging comprehensive judgment results were taken as the gold standard.Cardiac color ultrasonography parameters[left ventricular ejection fraction level(LVEF),left atrial diameter(LAD),left ventricular end-diastolic diameter(LVEDD)and maximum filling velocity peak(peak A)ratio in late mitral diastolic(E/A)]were analyzed and compared between the two groups.According to whether the MACE event occurred in the research group 6 months after discharge,the patients in the research group were further divided into the non-occurrence group and the occurrence group.The parameters of cardiac color ultrasonography were analyzed and compared between the non-occurrence group and the occurrence group.Receiver operating characteristic curve(ROC)was used to analyze the predictive value of cardiac color ultrasonography parameters for MACE events.Results:The LAD,LVEDD and LVEF of the study group were significantly higher than those of the control group,and the E/A of the study group was significantly lower than that of the control group(P<0.05).LAD,LVEDD and LVEF in the non-occurrence group were significantly lower than those in the occurrence group,and E/A was significantly higher than that in the occurrence group(P<0.05).The diagnostic sensitivity,specificity and accuracy were 90.00%,95.00%and 92.50%,respectively,and the missed diagnosis rate was 10.00%.The predicted AUC of HFpEF patients was 0.939,the predictive sensitivity was 92.00%,th

关 键 词：心脏彩超 射血分数保留心力衰竭 主要不良心血管事件 

分 类 号：X70[环境科学与工程—环境工程]